Expert Take On New Dietary Guidelines

The government released their new dietary guidelines yesterday. This is the first update in five years and it included 23 recommendations for the general population (and six specific ones for certain groups of people). The new recommendations are very prescriptive, rather than general, says Keith Ayoob, Ed.D., associate clinical professor of pediatrics and director of the Nutrition Clinic at the Albert Einstein College of Medicine Children's Evaluation and Rehabilitation Center. "They are intended to address the needs of most people and acknowledge that many Americans have health risks," he says.

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Here are some of the key changes and additions, along with expert input:

- Salt: The sodium recommendation is perhaps the most controversial change. It is now recommended that those who are over 51, African American, have hypertension, diabetes or chronic kidney disease, limit their sodium intake to 1,500 mg daily. For everyone else, the number to shoot for is 2,300 mg per day or less. The biggest sodium culprit? Processed foods. "Over 70% of our intake comes from these foods and food manufacturers will need to reduce (or continue to) the sodium in their products," says Joan Salge-Blake, RD, clinical associate professor of nutrition at Boston University. Although reducing sodium is a good idea for many reasons, not everyone is sure that this number is realistic. "The 1,500 mg limit is going to be next to impossible for many people to achieve," says Ayoob. "It's more restrictive than the average low-sodium diet in a hospital and I'd be happy if people got close to the 2,300 mg that these guidelines recommend for the under 50 age group."

- Obesity focus: The first couple suggestions encourage improved eating, controlling total calorie intake and increased physical activity to prevent obesity. "This is the first time that there is a large concern about obesity," says Salge-Blake. "We know that over 65% of Americans need to reduce their waistline and the most serious concern is for American's youth; childhood obesity has tripled since the 1980s."

- Emphasis on fruits/veggies/whole grains/seafood: The guidelines suggest that individuals should increase fruit and veggie intake, eat a variety of vegetables (especially dark-green and red and orange vegetables and beans and peas), consume at least half of all grains as whole and increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry. "There's almost no downside to plant-based diets," says Ayoob. "But there's also no question that lean meat can be a good part of a healthy diet." Its just a matter of what (leaner is better) and how much (people tend to eat larger portions of meat compared to something like scallops) you consume, he explains.

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- Vitamin B12: The one specific recommendation for those 50 years and older is to consume foods fortified with vitamin B12, such as fortified cereals or dietary supplements. Why this one vitamin in particular and why not from natural sources? Older people tend to have less ability to absorb B12 (important for the nervous system and other body functions) due to a decline in their stomach acid and other aging factors, says Ayoob. B12 is only found naturally in animal foods, especially meat, poultry, and fish. About 10 to 30 percent of people in this age group won't properly absorb the vitamin B12 in animal food sources, says Salge-Blake. So if you eat less meat and more plant-based proteins, plus, aren't able to absorb it very well, it's difficult to get enough naturally. That's where fortified foods and supplements come in.

Salge-Blake's bottom line: Eating a more plant-based, nutrient-rich, healthy diet that has all the food groups is the way to go. Fruits, veggies, and whole grains are all naturally low in heart unhealthy fat and sodium. Mother Nature will never steer you wrong!

Ayoob's bottom line: People shouldn't fret just because they don't get to 1500 mg. of sodium in their diets. That's probably not realistic for most people but that doesn't mean they shouldn't make some effort to reduce their sodium intake. Do what you can, take your time, and keep at it. No need to be perfect and we shouldn't let "perfect" be the enemy of "better." Most people can and should try to eat better overall.

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